Predischarge C-Reactive Protein and 1-year Outcome After Acute Coronary Syndromes - 20/08/11
, Philippe Ravaud, MD, PhD b, Alain Tedgui, PhD c, Jacques Puel, MD d, Dominique Moyse, MD e, Emmanuelle Curaudeau, MS f, Steven W. Quentzel, MD gELISCOR Investigators
Requests for reprints should be addressed to Philippe Gabriel Steg, MD, Hôpital Bichat, 46 rue Henri Huchard, 75877 Paris Cedex 18, FranceAbstract |
Purpose |
To investigate the relationship between high-sensitivity C-reactive protein and cardiovascular events following acute coronary syndrome.
Methods |
This nationwide, cross-sectional, prospective study involved 439 patients with an acute coronary syndrome who presented to the hospital within 24 hours of symptom onset. Patients with a concomitant inflammatory process were excluded. Predischarge C-reactive protein samples were measured using a high-sensitivity method in a core laboratory. The outcome was the composite of death, acute myocardial infarction, stroke/transient ischemic attack, urgent hospitalization for unstable angina, and urgent revascularization within 1 year.
Results |
At 1 year, event rates were 10.2% for the lowest, 8.2% for the middle, and 11.0% for the highest C-reactive protein tertiles (P = .75) with similar event-free survival (P = .70). The hazard ratio (HR) for event rates between the highest and lowest tertiles was 1.10 (95% confidence interval [CI]: 0.54 to 2.20) There was marked overlap of C-reactive protein values between patients with and without events (median [interquartile range]: 8.39 [3.27 to 32.63] vs 9.55 [4.07 to 24.02], respectively; P = .91). C-reactive protein was not an independent predictor of 1-year events (HR for highest tertile: 1.19; 95% CI: 0.58 to 2.43; P = .64) and performed poorly on receiver operating characteristic curve analysis (C statistic = 0.51).
Conclusion |
Predischarge high-sensitivity C-reactive protein level is a poor predictor of cardiovascular events at 1 year after acute coronary syndrome.
Le texte complet de cet article est disponible en PDF.Keywords : High-sensitivity C-reactive protein, Acute coronary syndromes, Cardiovascular events, Outcomes
Plan
| Supported by an unrestricted grant from Bristol-Myers Squibb, France. ELISCOR was supported by an unrestricted grant from Bristol-Myers Squibb, Rueil-Malmaison, France. The complete list of ELISCOR Investigators is in the Appendix. |
Vol 119 - N° 8
P. 684-692 - août 2006 Retour au numéro
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